Cardiac rehabilitation — also called cardiac rehab — is a customized outpatient program of exercise and education. Cardiac rehabilitation is designed to help you recover from a heart attack, other forms of heart disease or surgery to treat heart disease.

Cardiac rehabilitation is often divided into phases that involve monitored exercise, nutritional counseling, emotional support, and support and education about lifestyle changes to reduce your risks of heart problems. The goals of cardiac rehabilitation are to establish an individualized plan to help you regain strength, to prevent your condition from worsening, to reduce your risk of future heart problems, and to improve your health and quality of life.

Cardiac rehabilitation programs increase your chances of survival. Both the American Heart Association and American College of Cardiology recommend cardiac rehabilitation programs.

Cardiac rehabilitation is an option for people with many forms of heart disease. In particular, you may benefit from cardiac rehabilitation if your medical history includes:

Heart attack

Coronary artery disease

Heart failure

Peripheral arterial disease

Chest pain (angina)

Cardiomyopathy

Certain congenital heart diseases

Coronary artery bypass surgery

Angioplasty and stents

Heart or lung transplant

Heart valve repair or replacements

Don't let your age hold you back from joining a cardiac rehabilitation program. People of all ages can benefit from cardiac rehabilitation.

Cardiac rehabilitation isn't appropriate for everyone who has had heart disease. Your health care team will evaluate your health, including reviewing your medical history, conducting a physical examination and performing tests, to make sure you're ready to start a cardiac rehabilitation program.

Rarely, some people suffer injuries, such as strained muscles or sprains, while exercising as a part of cardiac rehabilitation. Your health care team will carefully monitor you while you exercise to lower this risk and will teach you how to avoid injuries when you exercise on your own.

If you've had a heart attack or heart surgery or if you have another heart condition, ask your doctor about joining a cardiac rehabilitation program. Insurance and Medicare often cover the costs of cardiac rehabilitation.

Cardiac rehabilitation can begin while you're still in the hospital and continue with monitored programs in an outpatient setting until home-based maintenance programs can be safely followed. Otherwise, it may start a few weeks after dismissal from the hospital, particularly after a heart attack or heart surgery.

The first stages of most cardiac rehabilitation programs last about three to six months. During that time, you'll work with a team of health care professionals, including cardiologists, nurse educators, dietitians, exercise rehabilitation specialists, occupational therapists, physical therapists, psychologists and psychiatrists.

Cardiac rehabilitation has four main parts:

Medical evaluation. Initial and ongoing evaluation will help your health care team check your physical abilities, medical limitations and other conditions you may have, and keep track of your progress over time.

During your evaluation, your health care team will look at your risk factors for heart disease or stroke. This will help your team tailor a cardiac rehabilitation program to your individual situation, making sure it's safe and effective.

Physical activity. Cardiac rehabilitation will improve your cardiovascular fitness through walking, cycling, rowing, or even jogging and other endurance activities. You may also do strength training (lifting weights, for example) to increase your muscular fitness.

Don't worry if you've never exercised before. Your cardiac rehabilitation team will make sure the program moves at a comfortable pace and is safe for you, but in general you should exercise three to five times a week. You'll be taught proper exercise techniques, such as warming up and stretching.

Lifestyle education. Guidance about nutrition can help you shed excess weight and learn to make healthier food choices aimed at reducing fat, sodium and cholesterol in your diet.

You'll also receive support and education on making lifestyle changes and breaking unhealthy habits, such as smoking. And you'll learn how to manage pain or fatigue. Cardiac rehabilitation also gives you ample opportunity to ask questions about such issues as sexual activity. Finally, it's critical you closely follow your doctor's advice on medications.

Support. Adjusting to a serious health problem often takes time. You may feel depressed or anxious, lose touch with your social support system, or have to stop working for several weeks.

If you get depressed, don't ignore it because depression can make your cardiac rehab program more difficult, as well as impact your relationships and other areas of your life and health. Counseling will help you learn healthy ways to cope with depression and other feelings. Your doctor may also suggest medications such as antidepressants. Vocational or occupational therapy will teach you new skills to help you return to work.

Although it may be difficult to start a cardiac rehabilitation program when you're not feeling well, you'll benefit in the long run. Cardiac rehabilitation can guide you through fear and anxiety as you return to an active lifestyle with more motivation and energy to do the things you enjoy.

Cardiac rehabilitation helps you rebuild your life, both physically and emotionally. As you get stronger and learn how to manage your condition, you'll likely return to a normal routine, along with your new diet and exercise habits. It's important to know that your chances of having a successful cardiac rehabilitation program rest largely with you; the more dedicated you are to following your program's recommendations, the better you'll do.

After cardiac rehabilitation

After your cardiac rehabilitation program ends, you'll need to continue the diet and exercise habits you learned for the rest of your life to maintain heart-health benefits.

Cardiac rehabilitation is a long-term maintenance program — something to follow for the rest of your life. After about 12 weeks, you probably will have developed your own exercise routine at home or at a local gym. You may also continue to exercise at a cardiac rehab center. You may remain under medical supervision during this time, particularly if you have special health concerns.

Education about nutrition, lifestyle and weight loss may continue, as well as counseling. To get the most benefits from cardiac rehabilitation, make sure your exercise and lifestyle practices become lifelong habits.

Over the long term, you'll gain strength; learn heart-healthy behaviors; improve your diet; cut bad habits, such as smoking; and learn how to cope with heart disease. You'll also decrease your risk of coronary artery disease and other heart conditions.

One of the most valuable benefits of cardiac rehabilitation is often an improvement in your overall quality of life. If you stick with your cardiac rehab program, you're likely to come out of the program feeling better than before.

References

What is cardiac rehabilitation? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/rehab/. Accessed April 16, 2014.

What is cardiac rehabilitation? American Heart Association. http://www.heart.org/HEARTORG/Conditions/More/CardiacRehab/What-is-Cardiac-Rehabilitation_UCM_307049_Article.jsp. Accessed April 16, 2014.

Thomas RJ, et al. AACVPR/ACC/AHA 2007 performance measures on cardiac rehabilitation for referral to and delivery of cardiac rehabilitation/secondary prevention services. Journal of the American College of Cardiology. 2007;50:1400.

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